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CORRESPONDENCE
Year : 2012  |  Volume : 57  |  Issue : 4  |  Page : 331-332
Clinicopathological evaluation of non-melanoma skin cancer


Division of Plastic Surgery, Department of Surgery, School of Medical Sciences, Universidade de Marília, Marília, São Paulo, Brazil

Date of Web Publication29-Jun-2012

Correspondence Address:
Rafael Denadai
Division of Plastic Surgery, Department of Surgery, School of Medical Sciences, Universidade de Marília, Marília, São Paulo
Brazil
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.97691

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How to cite this article:
Denadai R, Kirylko L, Souto LR. Clinicopathological evaluation of non-melanoma skin cancer. Indian J Dermatol 2012;57:331-2

How to cite this URL:
Denadai R, Kirylko L, Souto LR. Clinicopathological evaluation of non-melanoma skin cancer. Indian J Dermatol [serial online] 2012 [cited 2020 Sep 21];57:331-2. Available from: http://www.e-ijd.org/text.asp?2012/57/4/331/97691


We read with great interest the recent study by Adinarayan and Krishnamurthy, [1] and although we agree with most of the article's aspects, there are some considerations, which we believe are necessary to make:

  1. According to several studies, [2],[3] the authors' [1] assertion that "skin cancers are relatively uncommon malignancies worldwide" seems misplaced. In fact, skin cancer is the most common cancer in humans, being a growing worldwide problem, especially in fair-skinned populations. Therefore, it is considered a global epidemic, leading to a huge demand and increased expenses with health services. [2],[3]
  2. Knowledge about the relationship between exposure to ultraviolet radiation and the development of non-melanoma skin cancer (NMSC) has been modified in recent years. [2],[3] Chronic sun exposure seems to be the main cause of squamous cell carcinoma (SCC). [2],[3] In contrast, basal cell carcinoma (BCC) occurs due to intermittent sunlight exposure and history of sunburns, especially during childhood and adolescence. [2],[3] Unlike, therefore, the aspects discussed by the authors. [1]
  3. Adinarayan and Krishnamurthy [1] evaluated the distribution of NMSC in different anatomical sites. Related to this, our group [4] and others [5] demonstrated recently that diagnostic accuracy varied according to the affected anatomical area of the body. In both the studies, [4],[5] diagnostic accuracy, when stratified by tumor site, was highest in places where more frequently lesions occur. It is feasible to assume that the behavior learned by doctors causes an excess of malignant lesions' diagnoses (BCC and SCC) at the respective locations of the body where they most commonly occur, and an underestimation of lesions in body sites where they are less frequent. [5] The domain of this diagnostic aspect is important, considering that the diagnosis of NMSC is predominantly clinical, and it is confirmed by histopathologic evaluation that errors can delay appropriate treatment, [2],[4] it is expected that doctors are able to accurately diagnose these skin lesions. [4] In this context, efforts should be taken to improve medical education regarding these lesions; [5] the diagnostic hypotheses should be based on a set of information (clinical appearance, location, and evolution of lesions) and not just on the anatomical site involved. [4],[5]


Finally, we congratulate and thank the authors for their contribution to the clinicopathological understanding and characterization of the NMSC.

 
   References Top

1.Adinarayan M, Krishnamurthy SP. Clinicopathological evaluation of nonmelanoma skin cancer. Indian J Dermatol 2011;56:670-2.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Madan V, Lear JT, Szeimies RM. Non-melanoma skin cancer. Lancet 2010;375:673-85.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  
3.Aceituno-Madera P, Buendía-Eisman A, Arias-Santiago S, Serrano-Ortega S. Changes in the incidence of skin cancer between 1978 and 2002. Actas Dermosifiliogr 2010;101:39-46.  Back to cited text no. 3
    
4.Silva RD, Souto LR. Evaluation of the diagnosis and treatment of non-melanoma skin cancer and its impacts on the prevention habits in a specific population of southeastern Brazil. Eur J Gen Med 2011;8:291-301.  Back to cited text no. 4
    
5.Heal CF, Raasch BA, Buettner PG, Weedon D. Accuracy of clinical diagnosis of skin lesions. Br J Dermatol 2008;159:661-8.  Back to cited text no. 5
[PUBMED]  [FULLTEXT]  




 

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